Latest & greatest articles for children

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Top results for children

201. WITHDRAWN: Grommets (ventilation tubes) for recurrent acute otitis media in children.

WITHDRAWN: Grommets (ventilation tubes) for recurrent acute otitis media in children. BACKGROUND: This is an update of a Cochrane review first published in The Cochrane Library in Issue 4, 2008 and previously updated in 2011.Acute suppurative otitis media is one of the most common infectious diseases in childhood. Recurrent acute otitis media is defined for the purposes of this review as either three or more acute infections of the middle ear cleft in a six-month period, or at least four (...) episodes in a year. Strategies for managing the condition include the assessment and modification of risk factors where possible, repeated courses of antibiotics for each new infection, antibiotic prophylaxis and the insertion of ventilation tubes (grommets). OBJECTIVES: To establish whether grommet insertion reduces the frequency of episodes of recurrent acute otitis media and the proportion of symptomatic children. SEARCH METHODS: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials

Cochrane2018

202. GP letter to improve medication adherence did not reduce unplanned care for children with asthma

GP letter to improve medication adherence did not reduce unplanned care for children with asthma NIHR DC | Signal - GP letter to improve medication adherence did not reduce unplanned care for children with asthma Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal GP letter to improve medication adherence did not reduce unplanned care for children with asthma Published on 14 March 2017 A one-off GP letter reminding parents of children with asthma to use their medications over (...) to reduce the high proportion of children receiving unplanned care in September (45% of children in the letter group compared to 44% in the control group). Most of the unplanned care was not for asthma, which may be why the letter had little impact. It remains unclear why children with asthma are more likely to access unplanned care. This NIHR-funded trial was large, well-designed and, despite problems with labelling planned and unplanned care, is likely to be reliable. Why was this study needed? About

NIHR Dissemination Centre2018

203. Risks and benefits of ondansetron for children with acute gastroenteritis

Risks and benefits of ondansetron for children with acute gastroenteritis NIHR DC | Signal - Risks and benefits of ondansetron for children with acute gastroenteritis Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Risks and benefits of ondansetron for children with acute gastroenteritis Published on 7 February 2017 Giving ondansetron to children with acute gastroenteritis can stop vomiting, reduce the risk of oral rehydration treatment failing, and reduce the chances (...) of needing intravenous rehydration. But the drug can worsen diarrhoea symptoms. This systematic review looked for evidence about ondansetron’s effectiveness in stopping vomiting and for any impact on diarrhoea or other side effects. Only five out of the 10 included trials reported on diarrhoea related outcomes and they all used different outcome measures so the results could not be combined. This means that although diarrhoea is a recognised side-effect, it is still not known to what extent children

NIHR Dissemination Centre2018

204. Nurses lack confidence in escalating or identifying children at risk of abuse and neglect

Nurses lack confidence in escalating or identifying children at risk of abuse and neglect NIHR DC | Signal - Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Published on 6 December 2016 On the face of it, nurses are well placed to safeguard children, but asking them about their experiences reveals (...) that they will take appropriate safeguarding action. There is also a tension between being seen as caring, compassionate and trustworthy, and watching for abuse and neglect in vulnerable families. Current training is not enough to equip nurses with the necessary skills to confidently and effectively safeguard children. Instead, education could be tailored to specific situations. These findings were based on international studies where child protection policies and services and the training and expectations

NIHR Dissemination Centre2018

205. Fluoride-based treatments alone are not enough to stop tooth decay in young children

Fluoride-based treatments alone are not enough to stop tooth decay in young children NIHR DC | Signal - Fluoride-based treatments alone are not enough to stop tooth decay in young children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Fluoride-based treatments alone are not enough to stop tooth decay in young children Published on 22 November 2016 Providing a set of additional fluoride-based treatments at dental appointments for children aged two to three years was no better (...) than health education at preventing tooth decay. A range of public health measures to reduce sugar consumption are also needed. The treatment involved providing fluoride toothpaste and applying a fluoride varnish to the teeth at each six-monthly appointment for three years. This large NIHR-funded trial in Northern Ireland found no difference in the number of children developing tooth decay, though children in the treatment arm had fewer teeth showing signs of decay. The estimated cost was £2,093

NIHR Dissemination Centre2018

206. Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children

Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children NIHR DC | Signal - Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Published on 22 November 2016 Regular daily steroid inhalers reduce the number of severe asthma exacerbations requiring soluble tablets or injections in wheezing (...) preschool children by about a third. Intermittent high-dose steroid inhalers, given only when symptoms of a cold begin, were also effective for children with occasional asthma or wheezing triggered by a virus. This strategy may reduce the overall dose of steroids given to these children, though adverse effects may still occur. Wheezing is initially treated with a β2 agonist inhaler which opens up the airways. UK guidelines recommend adding in a daily low-dose steroid inhaler if symptoms are persistent

NIHR Dissemination Centre2018

207. Young children from deprived areas are more at risk of serious burns and scalds

Young children from deprived areas are more at risk of serious burns and scalds NIHR DC | Signal - Young children from deprived areas are more at risk of serious burns and scalds Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Young children from deprived areas are more at risk of serious burns and scalds Published on 24 January 2017 Five in every 1,000 children under four are injured by burns and scalds each year in England, although these injuries are becoming less common (...) . Serious injuries needing hospital treatment happen more often to children from deprived areas than wealthy areas. The study looked at general practice data from 1998 to 2013. It showed a steady decline in children having burns and scalds over the 15 year period, and the gap between least- and most-deprived areas has narrowed. However, children from the most deprived areas are more than twice as likely to need hospital treatment. Children aged 15 to 17 months are most at risk. Most burns and scalds

NIHR Dissemination Centre2018

208. Parent-focused therapy has some long-term benefits for children with autism

Parent-focused therapy has some long-term benefits for children with autism NIHR DC | Signal - Parent-focused therapy has some long-term benefits for children with autism Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Parent-focused therapy has some long-term benefits for children with autism Published on 14 February 2017 A parent-focused therapy for young children with autism continues to have beneficial effects on symptoms and communication almost six years after the end (...) of treatment. This UK randomised controlled trial investigated the effects of a one-year social communication therapy in 152 UK children aged two to four years with severe autism. The therapy, partly delivered by parents, aimed to help them adapt their style of interacting with their child. Children who received the intervention had less severe symptoms at the end of the initial one-year intervention period than those who received treatment as usual. When these children were followed up nearly six years

NIHR Dissemination Centre2018

209. Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease

Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease NIHR DC | Signal - Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems (...) in children under five with the rare vascular disease, Kawasaki disease. The disease needs to be recognised early, but can be hard to spot outside specialist care because it is so rare. It is now the commonest cause of acquired heart disease in children and delayed diagnosis can have serious consequences. Blood vessels supplying the heart become inflamed, increasing the risk of heart attack and death in later life. The disease is about 20 times more common in people of Japanese origin. This summary

NIHR Dissemination Centre2018

210. Very strict blood sugar control in critically ill children provides no benefit

Very strict blood sugar control in critically ill children provides no benefit NIHR DC | Signal - Very strict blood sugar control in critically ill children provides no benefit Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Very strict blood sugar control in critically ill children provides no benefit Published on 23 May 2017 Strict control of blood sugar levels for critically ill children in ICU with high blood sugar did not increase the number of days they spent outside (...) of ICU in the first month. The trial was stopped early as more infections and very low glucose levels were recorded in the strict control group. This trial found that using insulin to control blood sugar to within 4.4 to 6.1 mmol/L, rather than 8.3 to 10mmol/L, in critically ill children made no difference to the number of days they spent in the intensive care unit. This trial indicates that maintaining blood sugar control within tight boundaries in this group is of no benefit and may be harmful

NIHR Dissemination Centre2018

211. Simple approaches to weight management of children and adolescents in primary care may not work

Simple approaches to weight management of children and adolescents in primary care may not work NIHR DC | Signal - Simple approaches to weight management of children and adolescents in primary care may not work Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Simple approaches to weight management of children and adolescents in primary care may not work Published on 8 November 2016 Brief education and motivational interventions delivered by primary care professionals in several (...) short consultations had only a marginal effect on weight loss among overweight or mildly obese children and young people. Obesity can cause immediate health and wellbeing issues in children but also has significant implications for their long term health. Given that many of these health problems will present in a primary care setting, commissioners have been interested in primary care based programmes to tackle obesity and the “intensity” of the intervention required to make a difference

NIHR Dissemination Centre2018

212. Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children

Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children NIHR DC | Signal - Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children Published on 8 November 2016 A reduction in tooth decay of about 27% can be expected from the supervised regular use of fluoride mouthrinsing (...) by school children. Tooth decay has a significant impact on health and wellbeing. It is more common in disadvantaged communities and can be prevented by good oral hygiene and diet with reduced sugar intake. Children and young people are encouraged to brush their teeth regularly with fluoride toothpaste and some schools in the UK have supervised programmes to encourage this. This review included 37 trials where children received supervised mouthrinsing in schools, but did not compare this with supervised

NIHR Dissemination Centre2018

213. Vomiting is the most common adverse effect among children and young people sedated for emergency procedures

Vomiting is the most common adverse effect among children and young people sedated for emergency procedures NIHR DC | Signal - Vomiting is the most common adverse effect among children and young people sedated for emergency procedures Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Vomiting is the most common adverse effect among children and young people sedated for emergency procedures Published on 27 September 2016 Vomiting is the most common adverse event when sedating (...) a child or young person undergoing a procedure in the emergency department, occurring in 55.5 out of 1,000 cases. Agitation occurred in 17.9/1,000 cases, and hypoxia – lack of oxygen – in 14.8 out of 1,000 cases. Serious breathing problems needing intervention to provide ventilation were rare, but highlight the need for experienced staff when giving sedation to children. This systematic review included 41 studies, six of which were UK-based. It pooled the frequency of adverse events when using

NIHR Dissemination Centre2018

214. “Triptans” can relieve migraines in children and adolescents

“Triptans” can relieve migraines in children and adolescents NIHR DC | Signal - “Triptans” can relieve migraines in children and adolescents Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal “Triptans” can relieve migraines in children and adolescents Published on 13 September 2016 Triptans, a migraine medication, relieve migraine headache completely within two hours compared to placebo. Ibuprofen was also effective but less well studied. This review was also reassuring (...) in that any side effects of treatment were mild. Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults. The findings support current guideline recommendations to prescribe nasal triptans for migraine in adolescents. Only nasal preparations are currently licensed for adolescents

NIHR Dissemination Centre2018

215. Early exposure to peanut snacks can lead to sustained protection in high-risk children

Early exposure to peanut snacks can lead to sustained protection in high-risk children NIHR DC | Signal - Early exposure to peanut snacks can lead to sustained protection in high-risk children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Early exposure to peanut snacks can lead to sustained protection in high-risk children Published on 10 May 2016 Early exposure, up to age five, to peanut products in children with severe eczema or egg allergy appears to induce tolerance (...) that is sustained when peanut products are later avoided, suggesting it is not necessary to keep eating peanuts long term. This trial and its follow up study examined the effect of giving peanut products to very young children (aged four to 11 months) who were at high risk of peanut allergy. Children given regular peanut butter snacks until five years of age were much less likely to have a peanut allergy than those avoiding peanuts. There was a benefit even if they had an initial positive skin prick test

NIHR Dissemination Centre2018

216. Central lines coated with antibiotics reduce bloodstream infections in children

Central lines coated with antibiotics reduce bloodstream infections in children NIHR DC | Signal - Central lines coated with antibiotics reduce bloodstream infections in children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Central lines coated with antibiotics reduce bloodstream infections in children Published on 10 May 2016 Children in intensive care had lower rates of infection when using antibiotic coated central lines (also called central venous catheters) compared (...) to standard central lines or those coated with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data

NIHR Dissemination Centre2018

217. Education targeted at both parents and GPs reduces antibiotic prescribing for children

Education targeted at both parents and GPs reduces antibiotic prescribing for children NIHR DC | Signal - Education targeted at both parents and GPs reduces antibiotic prescribing for children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Education targeted at both parents and GPs reduces antibiotic prescribing for children Published on 30 August 2016 Interventions aimed at improving communication between GPs and parents could reduce unnecessary antibiotic prescribing (...) for childhood upper respiratory infections, such as the common cold. Inappropriate use of antibiotics has contributed to antibiotic resistance, resulting in impossible or difficult to treat infections. Parents, as well as GPs, influence the decision to prescribe antibiotics. Educational interventions that target both groups appear to be more effective at reducing prescriptions than those focussing on either group on their own. This information came from a systematic review of 12 studies conducted in high

NIHR Dissemination Centre2018

218. A simple test can help point to serious illness in children

A simple test can help point to serious illness in children NIHR DC | Signal - A simple test can help point to serious illness in children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal A simple test can help point to serious illness in children Published on 18 November 2015 This review found that the capillary refill test was useful in diagnosing serious illness or dehydration in children. The quick test, done by pressing on the nail bed, is used to monitor blood flow (...) . The review of studies testing its accuracy showed it can be used as a “red-flag” to identify (i.e.rule in) potential serious disease when present. The test’s low sensitivity means that a normal capillary refill time should not reassure clinicians that serious illness is absent (i.e.rule it out). Children with prolonged capillary refill time were shown to have a four-fold risk of dying compared with children with normal capillary refill time. However, other clinical markers of risk were more useful

NIHR Dissemination Centre2018

219. Whooping cough infection common in school aged children with stubborn coughs

Whooping cough infection common in school aged children with stubborn coughs NIHR DC | Signal - Whooping cough infection common in school aged children with stubborn coughs Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Whooping cough infection common in school aged children with stubborn coughs Published on 26 June 2014 This NIHR-funded study found that almost a fifth of children aged five to 15 years who visited their GP with persistent cough showed signs of recent (...) whooping cough infection, despite having a booster vaccination before school age. These data, from 22 GP practices in Thames Valley UK, describe the duration of vaccine-induced immunity and the burden of disease in adolescents. This may inform policy discussion about the potential need for a national adolescent whooping cough booster programme in the UK. Why was this study needed? Whooping cough (pertussis) is one of the most common vaccine preventable diseases causing almost 300,000 childhood deaths a year

NIHR Dissemination Centre2018

220. Blowing up a balloon with the nose helps restore hearing in children with glue ear

Blowing up a balloon with the nose helps restore hearing in children with glue ear NIHR DC | Signal - Blowing up a balloon with the nose helps restore hearing in children with glue ear Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Blowing up a balloon with the nose helps restore hearing in children with glue ear Published on 7 September 2015 The use of a simple nasal balloon can help restore hearing in children aged 4 to 11 with glue ear. After 3 months, this non-surgical (...) treatment restored normal hearing to 49.6% of children with glue ear compared with 38.3% receiving usual care. Children inflate the balloon by blowing it up with their noses rather than their mouths. The activity which is done three times a day can be taught by nurses in a GP surgery. Few non-surgical treatments exist for children with glue ear. Some, such as antibiotics, are used despite evidence they don’t work. It is hoped using the nasal balloon may help reduce this unnecessary use of antibiotics

NIHR Dissemination Centre2018